This article is from the source 'guardian' and was first published or seen on . It last changed over 40 days ago and won't be checked again for changes.
You can find the current article at its original source at http://www.theguardian.com/society/live/2016/jan/18/this-is-the-nhs-live-blog
The article has changed 65 times. There is an RSS feed of changes available.
Previous version
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
Next version
| Version 39 | Version 40 |
|---|---|
| This is the NHS: live from a 111 call handling centre in Newcastle | This is the NHS: live from a 111 call handling centre in Newcastle |
| (35 minutes later) | |
| 9.35am GMT | 9.35am GMT |
| 09:35 | 09:35 |
| Jessica Elgot | Jessica Elgot |
| Today, Alicia and I are at North East ambulance service’s 111 centre in Newcastle, where we’ll be speaking to call handlers about how they deal with a huge range of different problems, and to medical advisers and management about the reputation of the service and the times of day, week or year it is under most strain. | Today, Alicia and I are at North East ambulance service’s 111 centre in Newcastle, where we’ll be speaking to call handlers about how they deal with a huge range of different problems, and to medical advisers and management about the reputation of the service and the times of day, week or year it is under most strain. |
| I'm here at @NEAmbulance in Newcastle to live blog from their 111 centre #ThisIsTheNHS pic.twitter.com/fqMn5MhXm2 | |
| Updated | Updated |
| at 10.27am GMT | |
| 7.50am GMT | 7.50am GMT |
| 07:50 | 07:50 |
| Today’s liveblogging will be starting a little later than usual, as Jessica is not due to arrive at the 111 centre until around 9.30am. Please check back then for full coverage. | Today’s liveblogging will be starting a little later than usual, as Jessica is not due to arrive at the 111 centre until around 9.30am. Please check back then for full coverage. |
| 7.47am GMT | 7.47am GMT |
| 07:47 | 07:47 |
| Wednesday's morning briefing | Wednesday's morning briefing |
| Mark Smith | Mark Smith |
| Welcome to day three of the Guardian’s ambitious series attempting to get under the skin of the NHS and tell the story of one of the most complex organisations in the world, through the voices of those on its frontline. | Welcome to day three of the Guardian’s ambitious series attempting to get under the skin of the NHS and tell the story of one of the most complex organisations in the world, through the voices of those on its frontline. |
| To get this morning briefing sent to your inbox each day please sign up here. | To get this morning briefing sent to your inbox each day please sign up here. |
| The big picture | The big picture |
| Our aspiration is to examine a broad range of issues, from the strains on A&E to standards of care for elderly people, the multi-layered issues surrounding mental health, chronic disease, the high cost of drugs and the impact of alcohol. And exciting treatments using new sciences and cutting-edge technology. | Our aspiration is to examine a broad range of issues, from the strains on A&E to standards of care for elderly people, the multi-layered issues surrounding mental health, chronic disease, the high cost of drugs and the impact of alcohol. And exciting treatments using new sciences and cutting-edge technology. |
| We want to understand the dilemmas over prioritisation, over-prescribing and the cost of drugs – and the fiendishly complicated way the service is managed and run. We want to address the question: do we have the NHS we need? The aim is to do this through diaries, fly-on-the-wall reporting, interviews, films and explanation. | We want to understand the dilemmas over prioritisation, over-prescribing and the cost of drugs – and the fiendishly complicated way the service is managed and run. We want to address the question: do we have the NHS we need? The aim is to do this through diaries, fly-on-the-wall reporting, interviews, films and explanation. |
| Yesterday we focused on the issues surrounding GPs and family practices, with our intrepid reporter Jessica Elgot liveblogging from the Haxby group of surgeries in York and Hull. | Yesterday we focused on the issues surrounding GPs and family practices, with our intrepid reporter Jessica Elgot liveblogging from the Haxby group of surgeries in York and Hull. |
| Among the professionals she spoke to was pharmacist Dan Hurley, who is based at the surgery rather than at a separate dispensing chemist. “We don’t have to be separate, which I think has been the tradition,” he said. “It makes sense for us to work together.” | Among the professionals she spoke to was pharmacist Dan Hurley, who is based at the surgery rather than at a separate dispensing chemist. “We don’t have to be separate, which I think has been the tradition,” he said. “It makes sense for us to work together.” |
| Guardian writer Zoe Williams also visited the Haxby group of surgeries for this study of the “new model army” of family doctors changing the way the NHS operates in communities across the UK. She writes: | Guardian writer Zoe Williams also visited the Haxby group of surgeries for this study of the “new model army” of family doctors changing the way the NHS operates in communities across the UK. She writes: |
| ... If reorganisation in the first place was a quest for modernity, Haxby is its beacon: its GPs were among the first to perform vasectomies on site, for example; one GP diagnosed a rash from a photo a patient sent him on Facebook; their onsite pharmacies employ full-time pharmacists, an economy of GP time that only a scaled-up practice could do. The surgeries train ex-paramedics as primary care practitioners, who treat some minor illnesses and injuries in the surgery | ... If reorganisation in the first place was a quest for modernity, Haxby is its beacon: its GPs were among the first to perform vasectomies on site, for example; one GP diagnosed a rash from a photo a patient sent him on Facebook; their onsite pharmacies employ full-time pharmacists, an economy of GP time that only a scaled-up practice could do. The surgeries train ex-paramedics as primary care practitioners, who treat some minor illnesses and injuries in the surgery |
| One of the highlights of the coverage was Severin Carrell’s special report from the most northerly GP practice in the UK: Hillswick health centre in Shetland, which has been run by Dr Susan Bowie for the past 21 years. The surgery, which serves 764 patients dispersed over 77 sq miles of open country, still exists thanks to Bowie’s efforts to subsidise it with profits from her dispensary and two holiday cottages. But Bowie is nervous about the future of her practice. She will retire soon and there is a chronic shortage of new family doctors across the UK. | One of the highlights of the coverage was Severin Carrell’s special report from the most northerly GP practice in the UK: Hillswick health centre in Shetland, which has been run by Dr Susan Bowie for the past 21 years. The surgery, which serves 764 patients dispersed over 77 sq miles of open country, still exists thanks to Bowie’s efforts to subsidise it with profits from her dispensary and two holiday cottages. But Bowie is nervous about the future of her practice. She will retire soon and there is a chronic shortage of new family doctors across the UK. |
| We also broke the news that the UK’s family doctors are the most stressed in the western world, according to new research by the world’s most influential health thinktank, the Health Foundation. Denis Campbell’s story reported that the situation is now so bad that almost 30% of British GPs plan to quit in the next five years due to their overwhelming workloads. | We also broke the news that the UK’s family doctors are the most stressed in the western world, according to new research by the world’s most influential health thinktank, the Health Foundation. Denis Campbell’s story reported that the situation is now so bad that almost 30% of British GPs plan to quit in the next five years due to their overwhelming workloads. |
| We also received fantastic news of the first ever Guardian liveblog baby, as Kerri Calthorpe gave birth to her son Rex hours after being featured in Monday’s live blog from St George’s hospital. | We also received fantastic news of the first ever Guardian liveblog baby, as Kerri Calthorpe gave birth to her son Rex hours after being featured in Monday’s live blog from St George’s hospital. |
| We are delighted to say that Kerri had a baby boy, Rex. Kerry was featured on the live blog @guardian @jessicaelgot pic.twitter.com/8q33EXxKQP | We are delighted to say that Kerri had a baby boy, Rex. Kerry was featured on the live blog @guardian @jessicaelgot pic.twitter.com/8q33EXxKQP |
| Today’s focus | Today’s focus |
| On this third day of our NHS series, we’re concentrating on the sharp end of emergency medicine – paramedics and ambulance personnel. Jessica Elgot is in the north-east of England and will be liveblogging from an ambulance service 111 call centre in Newcastle. | On this third day of our NHS series, we’re concentrating on the sharp end of emergency medicine – paramedics and ambulance personnel. Jessica Elgot is in the north-east of England and will be liveblogging from an ambulance service 111 call centre in Newcastle. |
| The 111 service was set up to triage urgent but non-life-threatening cases, and help reduce the strain on 999 call handlers. But it has come in for heavy criticism over the last 18 months, both for supposedly creating congestion in hospitals by sending too many patients to A&E departments, and for not sending others who perhaps should have gone. There have been claims that the service is staffed by unskilled workers with too little supervision from clinicians, and complaints that the algorithm that prompts handlers’ questions is too formulaic. | The 111 service was set up to triage urgent but non-life-threatening cases, and help reduce the strain on 999 call handlers. But it has come in for heavy criticism over the last 18 months, both for supposedly creating congestion in hospitals by sending too many patients to A&E departments, and for not sending others who perhaps should have gone. There have been claims that the service is staffed by unskilled workers with too little supervision from clinicians, and complaints that the algorithm that prompts handlers’ questions is too formulaic. |
| Jessica will be talking to the call handlers and clinicians on the frontline to hear their perspective, and get a sense of the types of call they have to deal with day to day. | Jessica will be talking to the call handlers and clinicians on the frontline to hear their perspective, and get a sense of the types of call they have to deal with day to day. |
| And of course we’ve got the latest from our regular series The NHS saved my life - and today’s secret diary is from an emergency paramedic. | And of course we’ve got the latest from our regular series The NHS saved my life - and today’s secret diary is from an emergency paramedic. |
| You can tweet me or Jessica (@marksmith174 or @jessicaelgot) and follow the conversation on Twitter using the hashtag #ThisIsTheNHS. We hope you stick with us throughout the day. | You can tweet me or Jessica (@marksmith174 or @jessicaelgot) and follow the conversation on Twitter using the hashtag #ThisIsTheNHS. We hope you stick with us throughout the day. |
| Yesterday’s most read | Yesterday’s most read |
| Updated | Updated |
| at 9.46am GMT | at 9.46am GMT |
| 6.50pm GMT | 6.50pm GMT |
| 18:50 | 18:50 |
| Thanks so much for joining us, and for all your comments and tweets. We’ll be back again tomorrow morning from 8am, when our focus will be on emergency medical care, paramedics and 999 call handlers. | Thanks so much for joining us, and for all your comments and tweets. We’ll be back again tomorrow morning from 8am, when our focus will be on emergency medical care, paramedics and 999 call handlers. |
| Updated | Updated |
| at 6.52am GMT | at 6.52am GMT |
| 6.00pm GMT | 6.00pm GMT |
| 18:00 | 18:00 |
| 'We need to take down the barriers' | 'We need to take down the barriers' |
| Jessica Elgot | Jessica Elgot |
| The shortage of GPs and the constant financial pressure on practices has led to some very creative thinking, Dr Mike Holmes says. He is the clinical lead for the Supporting Federations programme at the Royal College of GPs and only sees patients a few times a week so he can spend time developing digital systems to ease the workload at the practice, and its financial burdens. | The shortage of GPs and the constant financial pressure on practices has led to some very creative thinking, Dr Mike Holmes says. He is the clinical lead for the Supporting Federations programme at the Royal College of GPs and only sees patients a few times a week so he can spend time developing digital systems to ease the workload at the practice, and its financial burdens. |
| Holmes brings up a list of hundreds of blood test results the practice sees in a single day: | Holmes brings up a list of hundreds of blood test results the practice sees in a single day: |
| Traditionally, a doctor might have looked at every single one, but if they are normal, there’s no reason a healthcare assistant can’t file them, and even be trained to file the more complex, multiple blood tests, if a doctor doesn’t need to take any action. We have people we think are capable of doing that in place, we just need to take down the barriers. | Traditionally, a doctor might have looked at every single one, but if they are normal, there’s no reason a healthcare assistant can’t file them, and even be trained to file the more complex, multiple blood tests, if a doctor doesn’t need to take any action. We have people we think are capable of doing that in place, we just need to take down the barriers. |
| Modern general practice has fewer doctors and less funding, but is far greater in complexity than it was before, he says. In 10 years, the number of consultations shot up 60%, with the number of blood tests up 300% and administrative work up 200%. | Modern general practice has fewer doctors and less funding, but is far greater in complexity than it was before, he says. In 10 years, the number of consultations shot up 60%, with the number of blood tests up 300% and administrative work up 200%. |
| “People are living longer, they have multiple, complex and chronic problems which are difficult to solve, and if we don’t start to address the issues now, we could see people start to lose confidence in GPs,” Holmes says. He will travel to London tomorrow for his work with the RCGP programme on federations – helping other GP practices to merge and work together, like Haxby has done. | “People are living longer, they have multiple, complex and chronic problems which are difficult to solve, and if we don’t start to address the issues now, we could see people start to lose confidence in GPs,” Holmes says. He will travel to London tomorrow for his work with the RCGP programme on federations – helping other GP practices to merge and work together, like Haxby has done. |
| It is a model very much favoured by NHS England and likely to become more common. “It’s working for us,” Holmes says. | It is a model very much favoured by NHS England and likely to become more common. “It’s working for us,” Holmes says. |
| We can work at scale, we can better meet patient demand, and we are gathering evidence to show as much as we can that it does improve patient care. New technology can help enormously, but of course it can’t ever replace the one on one with a doctor. We have tried consultations by Skype – it works for some people but for others it doesn’t. Sometimes there’s just no replacement for face to face. | We can work at scale, we can better meet patient demand, and we are gathering evidence to show as much as we can that it does improve patient care. New technology can help enormously, but of course it can’t ever replace the one on one with a doctor. We have tried consultations by Skype – it works for some people but for others it doesn’t. Sometimes there’s just no replacement for face to face. |
| His last patient of the day is Geoffrey Brown, in for a combination anaesthetic and cortisone injection for his arthritic knee. “They’ve put me through a lot of pain over the years here,” Brown says as he climbs on to the bed in the consulting room. “But I have no complaints at all, every doctor I see is brilliant.” | His last patient of the day is Geoffrey Brown, in for a combination anaesthetic and cortisone injection for his arthritic knee. “They’ve put me through a lot of pain over the years here,” Brown says as he climbs on to the bed in the consulting room. “But I have no complaints at all, every doctor I see is brilliant.” |
| Updated | Updated |
| at 6.06pm GMT | at 6.06pm GMT |
| 5.36pm GMT | 5.36pm GMT |
| 17:36 | 17:36 |
| Lesley Rientoul, senior receptionist | Lesley Rientoul, senior receptionist |
| Jessica Elgot | Jessica Elgot |
| “There’s a reputation that we are dragons,” says Lesley Rientoul, senior receptionist at the practice. “We’re really not, but we have to ask the questions.” | “There’s a reputation that we are dragons,” says Lesley Rientoul, senior receptionist at the practice. “We’re really not, but we have to ask the questions.” |
| Around her, other receptionists are taking appointments and reassuring patients who are ringing up for blood test results. | Around her, other receptionists are taking appointments and reassuring patients who are ringing up for blood test results. |
| How many calls does she answer in a day? “Hundreds. Absolutely hundreds. Anything from 30 seconds to five minutes. It’s a lot of responsibility. We have to decide where to send them – to a doctor, a nurse, even to say they should go to hospital. And we have to get it right.” | How many calls does she answer in a day? “Hundreds. Absolutely hundreds. Anything from 30 seconds to five minutes. It’s a lot of responsibility. We have to decide where to send them – to a doctor, a nurse, even to say they should go to hospital. And we have to get it right.” |
| No matter how difficult a patient can be, Rientoul says she tries to remain very, very calm. “It’s hard sometimes, though.” | No matter how difficult a patient can be, Rientoul says she tries to remain very, very calm. “It’s hard sometimes, though.” |
| 5.00pm GMT | 5.00pm GMT |
| 17:00 | 17:00 |
| Dr Mike Holmes, Haxby Group partner | Dr Mike Holmes, Haxby Group partner |
| Jessica Elgot | Jessica Elgot |
| Dr Mike Holmes, a partner in the Haxby group, is seeing one of his regulars, Keith Pearson, 73, who is keen to get back to his regular tennis game after being told to rest up after a bad chest infection. “I caught a cold in the pub, fella gave it to four of us,” he says. | Dr Mike Holmes, a partner in the Haxby group, is seeing one of his regulars, Keith Pearson, 73, who is keen to get back to his regular tennis game after being told to rest up after a bad chest infection. “I caught a cold in the pub, fella gave it to four of us,” he says. |
| Holmes tells him his chest sounds fine but he should try not to tear around the court too much. | Holmes tells him his chest sounds fine but he should try not to tear around the court too much. |
| “I feel much better now,” Pearson says. “But there were times I couldn’t breathe and that was quite frightening. I sing, do entertainment and do magic shows for the kids but I cancelled all my gigs. I want to get back to it.” | “I feel much better now,” Pearson says. “But there were times I couldn’t breathe and that was quite frightening. I sing, do entertainment and do magic shows for the kids but I cancelled all my gigs. I want to get back to it.” |
| Holmes suspects Pearson has had chronic bronchitis, but that it is now improving well. Pearson travels across the city to see Holmes since the doctor moved from the partner practice. He has been treated by him for at least five years, including for prostate cancer, which Pearson spotted the early symptoms of after reading a poster about the warning signs in the waiting room of the GP. | Holmes suspects Pearson has had chronic bronchitis, but that it is now improving well. Pearson travels across the city to see Holmes since the doctor moved from the partner practice. He has been treated by him for at least five years, including for prostate cancer, which Pearson spotted the early symptoms of after reading a poster about the warning signs in the waiting room of the GP. |
| “It is touching, when someone is so determined to come back and see you,” Holmes says. “I had one family where the husband had Huntington’s disease who I saw for 10 years, looking after him and his wife through the entire progression of the disease. That was one family which really taught me, more than anything, the value of general practice.” | “It is touching, when someone is so determined to come back and see you,” Holmes says. “I had one family where the husband had Huntington’s disease who I saw for 10 years, looking after him and his wife through the entire progression of the disease. That was one family which really taught me, more than anything, the value of general practice.” |
| Updated | Updated |
| at 5.08pm GMT | at 5.08pm GMT |
| 3.39pm GMT | 3.39pm GMT |
| 15:39 | 15:39 |
| UK's family doctors are most stressed in western world | UK's family doctors are most stressed in western world |
| We’ve just launched another important news story from Denis Campbell, the Guardian’s health policy editor. | We’ve just launched another important news story from Denis Campbell, the Guardian’s health policy editor. |
| Stress levels are so acute among British GPs that almost 30% plan to quit in the next five years, new research by the world’s most influential health thinktank reveals. | Stress levels are so acute among British GPs that almost 30% plan to quit in the next five years, new research by the world’s most influential health thinktank reveals. |
| Campbell reports: | Campbell reports: |
| Just under six in 10 GPs (59%) find their work stressful, with 39% of these saying it is very stressful| and 20% extremely stressful, which is higher than any other leading western nation in the triannual study. Researchers surveyed 11,547 GPsin 11 countries, including France, Germany and the United States. | Just under six in 10 GPs (59%) find their work stressful, with 39% of these saying it is very stressful| and 20% extremely stressful, which is higher than any other leading western nation in the triannual study. Researchers surveyed 11,547 GPsin 11 countries, including France, Germany and the United States. |
| “These worrying findings reveal the scale of the challenge facing general practice,” said Dr Jennifer Dixon, chief executive of the UK-based Health Foundation thinktank, which helped with the study. | “These worrying findings reveal the scale of the challenge facing general practice,” said Dr Jennifer Dixon, chief executive of the UK-based Health Foundation thinktank, which helped with the study. |
| Researchers found that family doctors in Britain spend less time with their patients than anywhere else. In all, 92% of the 1,001 GPs surveyed said they spent less than 15 minutes talking to patients, while internationally in the survey just 27% of GPs spent less than this time. Similarly, only 8% of NHS GPs are spending more than 15 minutes with patients; on average, almost three-quarters (73%) of patients get at least that long. | Researchers found that family doctors in Britain spend less time with their patients than anywhere else. In all, 92% of the 1,001 GPs surveyed said they spent less than 15 minutes talking to patients, while internationally in the survey just 27% of GPs spent less than this time. Similarly, only 8% of NHS GPs are spending more than 15 minutes with patients; on average, almost three-quarters (73%) of patients get at least that long. |
| You can read the full story here. | You can read the full story here. |
| Related: NHS has the west's most stressed GPs, survey reveals | Related: NHS has the west's most stressed GPs, survey reveals |
| Updated | Updated |
| at 4.14pm GMT | at 4.14pm GMT |
| 3.20pm GMT | 3.20pm GMT |
| 15:20 | 15:20 |
| 'We do home visits every day' | 'We do home visits every day' |
| Jessica Elgot | Jessica Elgot |
| The doctors are out on the road at lunchtime, making home visits. Gale Farm’s staff average more than 40 trips to patients’ houses each day. | The doctors are out on the road at lunchtime, making home visits. Gale Farm’s staff average more than 40 trips to patients’ houses each day. |
| “People think we don’t do this any more, but we do, every day,” says Dr Chris Stanley. “The majority are older patients who can’t get to the surgery. We can travel quite a distance, sometimes to the villages outside York.” | “People think we don’t do this any more, but we do, every day,” says Dr Chris Stanley. “The majority are older patients who can’t get to the surgery. We can travel quite a distance, sometimes to the villages outside York.” |
| The first stop is Audrey Shillitoe, who is struggling with lung disease and sounded breathless on the phone. Stanley, seeing this patient for the first time, said he was concerned he would have to convince her to go to hospital, but when he arrives at her home, his checks found she was doing a little better than expected. | The first stop is Audrey Shillitoe, who is struggling with lung disease and sounded breathless on the phone. Stanley, seeing this patient for the first time, said he was concerned he would have to convince her to go to hospital, but when he arrives at her home, his checks found she was doing a little better than expected. |
| “I hate going to hospital,” Shillitoe said. “Once they put me in a ward with alcoholics and drug addicts, and I thought to myself, I don’t ever want to go back.” Stanley prescribes her medication but told her to get in touch quickly if things get worse. | “I hate going to hospital,” Shillitoe said. “Once they put me in a ward with alcoholics and drug addicts, and I thought to myself, I don’t ever want to go back.” Stanley prescribes her medication but told her to get in touch quickly if things get worse. |
| Shillitoe was full of praise for the doctors, but said she was feeling the loss of a regular case management nurse visit, which cannot continue because of funding cuts. | Shillitoe was full of praise for the doctors, but said she was feeling the loss of a regular case management nurse visit, which cannot continue because of funding cuts. |
| Stanley asked her to call him to ask for extra help at home if she needed it. “Everyone criticises the NHS, but it isn’t their fault, the doctors and nurses; it’s others that are trying to cut things,” she said. “If these doctors weren’t here, I wouldn’t be here.” | Stanley asked her to call him to ask for extra help at home if she needed it. “Everyone criticises the NHS, but it isn’t their fault, the doctors and nurses; it’s others that are trying to cut things,” she said. “If these doctors weren’t here, I wouldn’t be here.” |
| The second stop on Stanley’s list of home visits is 87-year-old Valerie Winter, who needs a check-up after a spell in hospital with pneumonia. She is keen to get better quickly so she can get back to her hobbies, drawing classes, tai chi, singing in a choir and a sequence dancing class, though she no longer does the dance steps and just attends for the company. | The second stop on Stanley’s list of home visits is 87-year-old Valerie Winter, who needs a check-up after a spell in hospital with pneumonia. She is keen to get better quickly so she can get back to her hobbies, drawing classes, tai chi, singing in a choir and a sequence dancing class, though she no longer does the dance steps and just attends for the company. |
| Stanley checks her blood pressure, listens to her chest, and checks her oxygen levels, as we as discussing her medication and organising prescriptions to be delivered tomorrow. | Stanley checks her blood pressure, listens to her chest, and checks her oxygen levels, as we as discussing her medication and organising prescriptions to be delivered tomorrow. |
| Winter rejects the need for any extra help around the house. “I’m going to get a cleaner in because I was doing it all myself.” But she doesn’t need help with dressing or cooking. “I do all the cooking, vegetables, everything. I can manage.” | Winter rejects the need for any extra help around the house. “I’m going to get a cleaner in because I was doing it all myself.” But she doesn’t need help with dressing or cooking. “I do all the cooking, vegetables, everything. I can manage.” |
| Though she seems lively, she said her time is hospital was bad. “It was the worst I’ve ever felt. But I always want to get better. It’s silly giving up, really.” | Though she seems lively, she said her time is hospital was bad. “It was the worst I’ve ever felt. But I always want to get better. It’s silly giving up, really.” |
| Updated | Updated |
| at 3.36pm GMT | at 3.36pm GMT |
| 3.12pm GMT | 3.12pm GMT |
| 15:12 | 15:12 |
| We have our first Guardian live blog baby! | We have our first Guardian live blog baby! |
| Those of you who were following the live blog yesterday may be anxious to hear news about Kerri Calthorpe, 31, who was described by nurses at St George’s hospital, Tooting, as being “halfway”, through her labour after 12 hours. | Those of you who were following the live blog yesterday may be anxious to hear news about Kerri Calthorpe, 31, who was described by nurses at St George’s hospital, Tooting, as being “halfway”, through her labour after 12 hours. |
| We are now pleased to announce that baby Rex has been safely delivered. Congratulations to Kerri, husband Harry, and all the staff at St George’s maternity unit! | We are now pleased to announce that baby Rex has been safely delivered. Congratulations to Kerri, husband Harry, and all the staff at St George’s maternity unit! |
| We are delighted to say that Kerri had a baby boy, Rex. Kerry was featured on the live blog @guardian @jessicaelgot pic.twitter.com/8q33EXxKQP | We are delighted to say that Kerri had a baby boy, Rex. Kerry was featured on the live blog @guardian @jessicaelgot pic.twitter.com/8q33EXxKQP |
| For those who may have missed yesterday’s post – here’s how we last saw Kerri: | For those who may have missed yesterday’s post – here’s how we last saw Kerri: |
| Updated | Updated |
| at 3.25pm GMT | at 3.25pm GMT |
| 2.28pm GMT | 2.28pm GMT |
| 14:28 | 14:28 |
| Dr Claire Anderton and Dr Bhavesh Desai, GPs | Dr Claire Anderton and Dr Bhavesh Desai, GPs |
| Jessica Elgot | Jessica Elgot |
| The shortage of up-and-coming GPs is a major challenge for the profession, with many newly qualified doctors preferring to work in hospitals. | The shortage of up-and-coming GPs is a major challenge for the profession, with many newly qualified doctors preferring to work in hospitals. |
| Some might be daunted by the heavy workload of a GP, including out-of-hours paperwork, says Dr Claire Anderton. She is mentor to registrar Dr Bhavesh Desai, who is in his last year of GP training at Gale Farm. “I think some consultants can try to tempt good junior doctors away from general practice – they think it’s just prescribing antibiotics all day,” Desai said. | Some might be daunted by the heavy workload of a GP, including out-of-hours paperwork, says Dr Claire Anderton. She is mentor to registrar Dr Bhavesh Desai, who is in his last year of GP training at Gale Farm. “I think some consultants can try to tempt good junior doctors away from general practice – they think it’s just prescribing antibiotics all day,” Desai said. |
| Anderton agrees there is a misconception that “it’s just coughs and colds”: | Anderton agrees there is a misconception that “it’s just coughs and colds”: |
| It is an incredibly complex and varied job, but it is a huge workload, and I think that is starting to be addressed. There is an awful lot of burnout. Other than that it is the best job on Earth: I have patients who feel like friends, and when two of them died recently, I felt like I had lost two friends. | It is an incredibly complex and varied job, but it is a huge workload, and I think that is starting to be addressed. There is an awful lot of burnout. Other than that it is the best job on Earth: I have patients who feel like friends, and when two of them died recently, I felt like I had lost two friends. |
| Desai made up his mind to pursue general practice after his third year, and has taken a particular interest in palliative care – particularly after looking after one patient for the last six weeks of his life. He said that, rather than dying in hospital, “it’s better for anyone to die at home”. | Desai made up his mind to pursue general practice after his third year, and has taken a particular interest in palliative care – particularly after looking after one patient for the last six weeks of his life. He said that, rather than dying in hospital, “it’s better for anyone to die at home”. |
| Anderton, who has been a GP for more than 20 years, said she was constantly learning. “I have learned particularly to always trust mothers when they say something is wrong with their children,” she said. “But Bhav has taught me so much, too, because he’s newly trained, particularly about new technology, he’s downloaded apps for me on my phone that help enormously with different aspects of patient care.” | Anderton, who has been a GP for more than 20 years, said she was constantly learning. “I have learned particularly to always trust mothers when they say something is wrong with their children,” she said. “But Bhav has taught me so much, too, because he’s newly trained, particularly about new technology, he’s downloaded apps for me on my phone that help enormously with different aspects of patient care.” |
| Aside from the workload, the only complaint Anderton has about her work is the effect of national politics: | Aside from the workload, the only complaint Anderton has about her work is the effect of national politics: |
| The NHS is a huge organisation, and it is adaptable. But we have had to deal with a horrendous amount of change, and we have to have some stability as well. We employ people here; and we ask them to do a job and if policies change it might change people’s jobs and we might have to make people redundant. The cuts have been happening for the last eight years, and we have to constantly try to innovate in order to keep ahead. | The NHS is a huge organisation, and it is adaptable. But we have had to deal with a horrendous amount of change, and we have to have some stability as well. We employ people here; and we ask them to do a job and if policies change it might change people’s jobs and we might have to make people redundant. The cuts have been happening for the last eight years, and we have to constantly try to innovate in order to keep ahead. |
| Updated | Updated |
| at 5.34pm GMT | at 5.34pm GMT |
| 12.56pm GMT | 12.56pm GMT |
| 12:56 | 12:56 |
| Lorraine Rankin, healthcare assistant | Lorraine Rankin, healthcare assistant |
| Jessica Elgot | Jessica Elgot |
| In her practice room, healthcare assistant Lorraine Rankin is carefully dressing her patient’s foot. Rachel has had surgery after falling down the stairs and developing a bunion-like lump on the side, near her toe. | In her practice room, healthcare assistant Lorraine Rankin is carefully dressing her patient’s foot. Rachel has had surgery after falling down the stairs and developing a bunion-like lump on the side, near her toe. |
| She has been having the wound dressed at the surgery every few days, but is keen to be rid of her crutches. “It’s only a couple more weeks now, I’m seeing the surgeon next week so I want it to look good for that.” | She has been having the wound dressed at the surgery every few days, but is keen to be rid of her crutches. “It’s only a couple more weeks now, I’m seeing the surgeon next week so I want it to look good for that.” |
| Rachel had an allergic reaction to one of the dressings so Rankin calls in practice nurse Laura Atherton for her advice on dressings to use. | Rachel had an allergic reaction to one of the dressings so Rankin calls in practice nurse Laura Atherton for her advice on dressings to use. |
| It is a new role for Rankin, with healthcare assistants now trained to take on a huge expansion in tasks, including not only dressing wounds but procedures such as ear syringes, flu jabs, NHS health checks and aiding surgical teams in vasectomies – jobs traditionally done by a practice nurse. | It is a new role for Rankin, with healthcare assistants now trained to take on a huge expansion in tasks, including not only dressing wounds but procedures such as ear syringes, flu jabs, NHS health checks and aiding surgical teams in vasectomies – jobs traditionally done by a practice nurse. |
| Both Rankin and Atherton sort through the dressings, showing Rachel different kinds. “I know the orange and the blue packets, and the orange ones were what I thought worked,” Rachel said. She prefers to remove the old dressing herself, to ease it over the most painful spots. With the dressing on, she hobbled out of the surgery. “It’s not too painful,” she winced. | Both Rankin and Atherton sort through the dressings, showing Rachel different kinds. “I know the orange and the blue packets, and the orange ones were what I thought worked,” Rachel said. She prefers to remove the old dressing herself, to ease it over the most painful spots. With the dressing on, she hobbled out of the surgery. “It’s not too painful,” she winced. |
| “If I was 10 years younger, I’d definitely train to be a practice nurse,” says Rankin. “But it’s the practical side that I like: if you do an ear syringe then it seems like not such a major procedure. But it can make a huge difference to someone – you see their face change and they are so grateful they can hear again.” | “If I was 10 years younger, I’d definitely train to be a practice nurse,” says Rankin. “But it’s the practical side that I like: if you do an ear syringe then it seems like not such a major procedure. But it can make a huge difference to someone – you see their face change and they are so grateful they can hear again.” |
| Rankin is planning to do a foundation course at York University to help her advance as a healthcare assistant. And this week she will be trained to administer shingles vaccinations – her first live vaccine. It is a major shift in her role from what she was doing initially, but Rankin said the practice is keen to give healthcare assistant more responsibility for simple procedures. “I’d like to train now so I can be at the top level of everything I’m allowed to do.” | Rankin is planning to do a foundation course at York University to help her advance as a healthcare assistant. And this week she will be trained to administer shingles vaccinations – her first live vaccine. It is a major shift in her role from what she was doing initially, but Rankin said the practice is keen to give healthcare assistant more responsibility for simple procedures. “I’d like to train now so I can be at the top level of everything I’m allowed to do.” |
| Updated | Updated |
| at 2.04pm GMT | at 2.04pm GMT |
| 12.39pm GMT | 12.39pm GMT |
| 12:39 | 12:39 |
| Dan Hurley, pharmacist | Dan Hurley, pharmacist |
| Jessica Elgot | Jessica Elgot |
| Dan Hurley has an unusual role – but it is one that could become far more common. | Dan Hurley has an unusual role – but it is one that could become far more common. |
| He is a pharmacist based in the Haxby Group’s GP practice, not in a separate chemist. The clinic has trialled the position for about 18 months, getting Hurley to deal with repeat prescriptions, manage patients with chronic conditions such as asthma, and monitor the drugs that patients take to make sure different medications are not conflicting with each other. | He is a pharmacist based in the Haxby Group’s GP practice, not in a separate chemist. The clinic has trialled the position for about 18 months, getting Hurley to deal with repeat prescriptions, manage patients with chronic conditions such as asthma, and monitor the drugs that patients take to make sure different medications are not conflicting with each other. |
| We might have someone on 20 or 30 medicines a day, with heart disease; then they might be overweight and that leads to diabetes and hypertension; they could have asthma on top of that, and chronic ulcers as a side-effect; then mental health problems caused by ill health. All this can add up when it comes to medication – and they might be seeing three different specialists. I can be there to keep track of what they are taking and spot conflicts. | We might have someone on 20 or 30 medicines a day, with heart disease; then they might be overweight and that leads to diabetes and hypertension; they could have asthma on top of that, and chronic ulcers as a side-effect; then mental health problems caused by ill health. All this can add up when it comes to medication – and they might be seeing three different specialists. I can be there to keep track of what they are taking and spot conflicts. |
| Hurley deals daily with patients who have seen miracle drugs and cures in newspapers or on the internet, or have concerns about their medication because of what they have seen in the press, or what their neighbours have told them. | Hurley deals daily with patients who have seen miracle drugs and cures in newspapers or on the internet, or have concerns about their medication because of what they have seen in the press, or what their neighbours have told them. |
| “It’s really hard. Take statins for example: professors of cardiology are divided over the minutiae of it so it’s very hard to explain in the lay press. And they read about some cures too, say for dementia, and that is really hard sometimes for family to cope with, especially if they read there’s a cure.” | “It’s really hard. Take statins for example: professors of cardiology are divided over the minutiae of it so it’s very hard to explain in the lay press. And they read about some cures too, say for dementia, and that is really hard sometimes for family to cope with, especially if they read there’s a cure.” |
| The NHS is keen to have more pharmacists like Hurley in GP practices around the country. “We don’t have to be separate, which I think has been the tradition, it makes sense for us to work together.” | The NHS is keen to have more pharmacists like Hurley in GP practices around the country. “We don’t have to be separate, which I think has been the tradition, it makes sense for us to work together.” |
| Updated | Updated |
| at 1.26pm GMT | at 1.26pm GMT |
| 12.32pm GMT | 12.32pm GMT |
| 12:32 | 12:32 |
| Your Tuesday lunchtime reading list | Your Tuesday lunchtime reading list |
| 76 prescriptions, 38 consultations, 55 lab results, 11 phonecalls, one home visit – all in one day: The latest in our secret diary series has launched, revealing the ups and downs of a single GP’s working week, from a patient aggressively demanding antibiotics to praise from a relieved mother. | 76 prescriptions, 38 consultations, 55 lab results, 11 phonecalls, one home visit – all in one day: The latest in our secret diary series has launched, revealing the ups and downs of a single GP’s working week, from a patient aggressively demanding antibiotics to praise from a relieved mother. |
| The NHS saved my life: ‘I was pregnant, alone and bleeding, but didn’t realise the danger.’ Read one woman’s account of how the quick and calm actions of staff at a GP surgery may have saved her and her baby. | The NHS saved my life: ‘I was pregnant, alone and bleeding, but didn’t realise the danger.’ Read one woman’s account of how the quick and calm actions of staff at a GP surgery may have saved her and her baby. |
| Updated | Updated |
| at 12.42pm GMT | at 12.42pm GMT |
| 12.02pm GMT | 12.02pm GMT |
| 12:02 | 12:02 |
| Your comments on our NHS series so far | Your comments on our NHS series so far |
| Elena Cresci | Elena Cresci |
| Readers have been getting involved with the project in a number of ways, whether below the line, on Facebook or via GuardianWitness. Yesterday’s 10 truths about the NHS piece led to this personal story from MysteryMachines: | Readers have been getting involved with the project in a number of ways, whether below the line, on Facebook or via GuardianWitness. Yesterday’s 10 truths about the NHS piece led to this personal story from MysteryMachines: |
| As someone who nearly died age 28, I am thankful for our amazing NHS every bloody day. They have saved my life and all I can really offer is its ridiculously comforting to know that throughout my treatment and rehab from a traumatic brain injury i would not receive a bill in the post for it. | As someone who nearly died age 28, I am thankful for our amazing NHS every bloody day. They have saved my life and all I can really offer is its ridiculously comforting to know that throughout my treatment and rehab from a traumatic brain injury i would not receive a bill in the post for it. |
| But that's the least of your problems as a patient, there are the countless nurses, doctors and staff keeping you going through what is undoubtedly the worst time of your life also for free. How dare they. | But that's the least of your problems as a patient, there are the countless nurses, doctors and staff keeping you going through what is undoubtedly the worst time of your life also for free. How dare they. |
| I had a 10-15% chance of instant death from my injury, I lived and received excellent care throughout my 3 month stay. I had brain surgery on 1st May to correct my problem, I was back at work 3 weeks later happy to pay my tax bit back in to help fund the NHS and help others help themselves. | I had a 10-15% chance of instant death from my injury, I lived and received excellent care throughout my 3 month stay. I had brain surgery on 1st May to correct my problem, I was back at work 3 weeks later happy to pay my tax bit back in to help fund the NHS and help others help themselves. |
| Underneath our piece about funding elderly and social care, janeinalberta shared her experiences as a relative providing unpaid care for the elderly: | Underneath our piece about funding elderly and social care, janeinalberta shared her experiences as a relative providing unpaid care for the elderly: |
| I'm one of the small army of relatives providing unpaid care for the very elderly and frail. I don't mind doing it, but it is challenging and I no longer have confidence that there will be back-up from social services and the NHS if I can't cope. I also worry about what will happen to myself and my husband in our extreme old age, since we do not have children of our own, and our own financial resources will be less because of the money being spent on my mother's care. | I'm one of the small army of relatives providing unpaid care for the very elderly and frail. I don't mind doing it, but it is challenging and I no longer have confidence that there will be back-up from social services and the NHS if I can't cope. I also worry about what will happen to myself and my husband in our extreme old age, since we do not have children of our own, and our own financial resources will be less because of the money being spent on my mother's care. |
| I'd be quite happy to forgo the fuel allowance and the 'triple lock' if it guaranteed that whatever my savings and income I'll get adequate care in my old age. But, I do not trust the government on this issue. The Care Act was supposed to solve the problem, but implementation turned into a farce. | I'd be quite happy to forgo the fuel allowance and the 'triple lock' if it guaranteed that whatever my savings and income I'll get adequate care in my old age. But, I do not trust the government on this issue. The Care Act was supposed to solve the problem, but implementation turned into a farce. |
| The index linking of my local government pension, and my husband's civil service and teacher's pensions has been reduced from RPI to CPI and recently we've discovered that part of my husband's pensions will lose their index linking altogether when the flat rate pension comes in -- and that is despite my husband not benefitting from the flat rate pension increase. So suggesting that we should lose further benefits, supposedly to pay for care, just adds further insecurity and uncertainty. | The index linking of my local government pension, and my husband's civil service and teacher's pensions has been reduced from RPI to CPI and recently we've discovered that part of my husband's pensions will lose their index linking altogether when the flat rate pension comes in -- and that is despite my husband not benefitting from the flat rate pension increase. So suggesting that we should lose further benefits, supposedly to pay for care, just adds further insecurity and uncertainty. |
| You’ve also been submitting your stories to our GuardianWitness callout. Hannah Harris wrote to us about how St George’s, the hospital we were liveblogging from yesterday, saved her six-week-old daughter: | You’ve also been submitting your stories to our GuardianWitness callout. Hannah Harris wrote to us about how St George’s, the hospital we were liveblogging from yesterday, saved her six-week-old daughter: |
| St George's saved my baby's life | St George's saved my baby's life |
| My daughter was blue lighted from Margate QEQM to St George's on New Year's Eve 2011. She was 6 weeks old and suffering with RSV Bronchiolitis. I remember feeling terrified and numb all at once in the ambulance sitting next to my tiny baby who was connected to all sorts of wires and machines. It was like some sort of out of body experience. This wasn't really happening I kept thinking. She'd had a bad turn on the ward at Margate and was rushed to the ICU where a room full of brilliant doctors and nurses managed to get her breathing again via mechanical means. There was no Paediatric Intensive Care Unit there though so she had to be transferred. | My daughter was blue lighted from Margate QEQM to St George's on New Year's Eve 2011. She was 6 weeks old and suffering with RSV Bronchiolitis. I remember feeling terrified and numb all at once in the ambulance sitting next to my tiny baby who was connected to all sorts of wires and machines. It was like some sort of out of body experience. This wasn't really happening I kept thinking. She'd had a bad turn on the ward at Margate and was rushed to the ICU where a room full of brilliant doctors and nurses managed to get her breathing again via mechanical means. There was no Paediatric Intensive Care Unit there though so she had to be transferred. |
| When we arrived at St George's in the early hours the ward was quiet, warm and peaceful. Not what I expected I suppose but then at the time I'm not sure I knew what to expect. More wonderful doctors were ready waiting to receive our little girl by a specially heated bed. They warned us things were going to get worse before they got better but they'd seen it all before and instilled such confidence in us over the time we spent there that it was all going to be ok. Our daughters case was a rare one, she was in the 1% of kids who react to the virus in the way she did but the doctors and nurses treated her and cared for her and watched her closely and after a long, hellish week she got better. Just like that. Just like they said she would. She is 4 years old now. She is at school, she has friends, she is thriving. I still can't believe how lucky we are to have our little girl sometimes. We were so close to losing her it seemed. A tiny 6 week old baby. 2 collapsed lungs. Non responsive. What if we weren't in that hospital at that time with the support and resources from both Margate and St George's? Well, it doesn't bear thinking about really, does it? | When we arrived at St George's in the early hours the ward was quiet, warm and peaceful. Not what I expected I suppose but then at the time I'm not sure I knew what to expect. More wonderful doctors were ready waiting to receive our little girl by a specially heated bed. They warned us things were going to get worse before they got better but they'd seen it all before and instilled such confidence in us over the time we spent there that it was all going to be ok. Our daughters case was a rare one, she was in the 1% of kids who react to the virus in the way she did but the doctors and nurses treated her and cared for her and watched her closely and after a long, hellish week she got better. Just like that. Just like they said she would. She is 4 years old now. She is at school, she has friends, she is thriving. I still can't believe how lucky we are to have our little girl sometimes. We were so close to losing her it seemed. A tiny 6 week old baby. 2 collapsed lungs. Non responsive. What if we weren't in that hospital at that time with the support and resources from both Margate and St George's? Well, it doesn't bear thinking about really, does it? |
| Sent via Guardian Witness | Sent via Guardian Witness |
| By Hannah Harris | By Hannah Harris |
| 18 January 2016, 16:08 | 18 January 2016, 16:08 |
| And we haven’t just been receiving stories from patients: we’ve also heard from NHS staff too. Greengables1, a ward sister, wrote about her concerns with staffing levels on hospital wards for GuardianWitness. | And we haven’t just been receiving stories from patients: we’ve also heard from NHS staff too. Greengables1, a ward sister, wrote about her concerns with staffing levels on hospital wards for GuardianWitness. |
| As always, you can get involved with our journalism below the line on this liveblog and on other selected pieces. You can also join the conversation using the hashtag #ThisIsTheNHS – that is, once Twitter is properly back on its feet. | As always, you can get involved with our journalism below the line on this liveblog and on other selected pieces. You can also join the conversation using the hashtag #ThisIsTheNHS – that is, once Twitter is properly back on its feet. |
| Updated | Updated |
| at 12.19pm GMT | at 12.19pm GMT |
| 11.55am GMT | 11.55am GMT |
| 11:55 | 11:55 |
| Junior doctors' strike suspended | Junior doctors' strike suspended |
| Next week’s strike by junior doctors has been suspended as talks continue with the government over new contracts, the British Medical Association has said. | Next week’s strike by junior doctors has been suspended as talks continue with the government over new contracts, the British Medical Association has said. |
| For the full story on this breaking news, click here. | For the full story on this breaking news, click here. |
| 11.41am GMT | 11.41am GMT |
| 11:41 | 11:41 |
| Laura Atherton, nurse | Laura Atherton, nurse |
| Jessica Elgot | Jessica Elgot |
| By mid-morning, nurse Laura Atherton is doing a diabetes patient’s yearly review. The patient has been taking notes of their blood sugar levels, and has adjusted their medication dosage recently, which they say has been having a positive affect. | By mid-morning, nurse Laura Atherton is doing a diabetes patient’s yearly review. The patient has been taking notes of their blood sugar levels, and has adjusted their medication dosage recently, which they say has been having a positive affect. |
| One thing they are concerned about is their weight. Atherton checks the patient’s BMI, but cautions that it is not an exact science. | One thing they are concerned about is their weight. Atherton checks the patient’s BMI, but cautions that it is not an exact science. |
| I get a lot of patients who have seen things in the media about new diets or nutrition, so I really do have to keep on top of it. People ask me things like ‘should I do the 5:2 diet?’ so I do have to know what it actually is. | I get a lot of patients who have seen things in the media about new diets or nutrition, so I really do have to keep on top of it. People ask me things like ‘should I do the 5:2 diet?’ so I do have to know what it actually is. |
| Her main guidance is on portion size and exercise. “I do tell them about BMI, but I’m far more concerned if they are getting active and eating healthy food than whether they have exactly the right numbers.” | Her main guidance is on portion size and exercise. “I do tell them about BMI, but I’m far more concerned if they are getting active and eating healthy food than whether they have exactly the right numbers.” |
| Atherton says she tries to be sensitive when discussing weight with patients. “I’m not a bullying kind of nurse. Often, I do find people are self-aware if you bring it up sensitively.” | Atherton says she tries to be sensitive when discussing weight with patients. “I’m not a bullying kind of nurse. Often, I do find people are self-aware if you bring it up sensitively.” |
| Though much of the discussion Atherton often has with diabetes patients is about diet, she checks their feet for signs of change to the nervous system, reminds them how to cope with a dip in blood sugar and talks to them about the new alcohol guidelines – particularly the recommendations that people should have at least a couple of days a week that are alcohol-free. | Though much of the discussion Atherton often has with diabetes patients is about diet, she checks their feet for signs of change to the nervous system, reminds them how to cope with a dip in blood sugar and talks to them about the new alcohol guidelines – particularly the recommendations that people should have at least a couple of days a week that are alcohol-free. |
| 11.00am GMT | 11.00am GMT |
| 11:00 | 11:00 |
| 'Apparently I was in a coma, but I don’t remember it' | 'Apparently I was in a coma, but I don’t remember it' |
| Jessica Elgot | Jessica Elgot |
| Cyril Reynolds, 78, used to swim three or four times a week. Early one Tuesday morning, he pulled himself out of the pool and into the showers to wash off. The next thing he remembers is waking up in hospital – on the Sunday. | Cyril Reynolds, 78, used to swim three or four times a week. Early one Tuesday morning, he pulled himself out of the pool and into the showers to wash off. The next thing he remembers is waking up in hospital – on the Sunday. |
| “Apparently I woke up from the coma on Friday but I don’t remember it. I’d had a massive heart attack, and the doctors told me I’d actually had an earlier one, which I didn’t realise.” | “Apparently I woke up from the coma on Friday but I don’t remember it. I’d had a massive heart attack, and the doctors told me I’d actually had an earlier one, which I didn’t realise.” |
| That heart attack was 16 years ago, but Reynolds is still coming for regular heart check-ups, as well as other matters that he says are a result of his age. He likes to see a regular GP, who knows his health history: | That heart attack was 16 years ago, but Reynolds is still coming for regular heart check-ups, as well as other matters that he says are a result of his age. He likes to see a regular GP, who knows his health history: |
| I saw a doctor here for many years who retired, but he knew me. He once said to me ‘come back in four days’ so I did, and he saw me in the waiting room, took one look at me and said ‘you look better than you did’. A computer can’t tell you that. I believe you have to know a person, and I don’t have that here now, but it’s something I’d like to have again with a new doctor. | I saw a doctor here for many years who retired, but he knew me. He once said to me ‘come back in four days’ so I did, and he saw me in the waiting room, took one look at me and said ‘you look better than you did’. A computer can’t tell you that. I believe you have to know a person, and I don’t have that here now, but it’s something I’d like to have again with a new doctor. |
| Updated | Updated |
| at 11.03am GMT | at 11.03am GMT |
| 10.34am GMT | 10.34am GMT |
| 10:34 | 10:34 |
| Should fitness trackers be part of the data your GP holds? | Should fitness trackers be part of the data your GP holds? |
| Samuel Gibbs | Samuel Gibbs |
| One key debate in the GP realm surrounds how to bring the NHS’s patient records into the digital era, such as using health data from personal smartphones and fitness trackers, and how to keep this data secure. | One key debate in the GP realm surrounds how to bring the NHS’s patient records into the digital era, such as using health data from personal smartphones and fitness trackers, and how to keep this data secure. |
| One group, Patients Know Best, believes the solution is to put the patient in control of their data, collating it into one central place that plugs directly into NHS systems and pulls in data from other sources, including personal devices. | One group, Patients Know Best, believes the solution is to put the patient in control of their data, collating it into one central place that plugs directly into NHS systems and pulls in data from other sources, including personal devices. |
| Dr Mohammad Al-Ubaydli, the founder and chief executive of Patients Know Best, said: | Dr Mohammad Al-Ubaydli, the founder and chief executive of Patients Know Best, said: |
| Patient control improves safety, raises quality, cuts costs and makes patients happier. It saves time for both patients and medical staff allowing modern communications, while making sure privacy is at its heart through strict controls over who has access to what based on patient consent. | Patient control improves safety, raises quality, cuts costs and makes patients happier. It saves time for both patients and medical staff allowing modern communications, while making sure privacy is at its heart through strict controls over who has access to what based on patient consent. |
| Giving patients access to their records, treatment plans and adding data from audited systems including the quantified self can more effectively guide their care. It’s a workflow for the medical team, but also for the patient to help them understand what’s happening and keep them informed about their treatment plan. | Giving patients access to their records, treatment plans and adding data from audited systems including the quantified self can more effectively guide their care. It’s a workflow for the medical team, but also for the patient to help them understand what’s happening and keep them informed about their treatment plan. |
| But Beverley Bryant, director of digital technology for NHS England, rejected this proposal: | But Beverley Bryant, director of digital technology for NHS England, rejected this proposal: |
| Frankly I think it’s a sad indictment of the NHS that the patient has to take control of their data in this way. I think citizens in England that use the NHS should reasonably expect that doctors and nurses that have treated them, hospitals, institutions and local authorities that have cared for them and their family, know stuff about them, like who they are, what treatments their on, what they’re allergic to. | Frankly I think it’s a sad indictment of the NHS that the patient has to take control of their data in this way. I think citizens in England that use the NHS should reasonably expect that doctors and nurses that have treated them, hospitals, institutions and local authorities that have cared for them and their family, know stuff about them, like who they are, what treatments their on, what they’re allergic to. |
| NHS England has pledged to move the health service to be paperless at the point of care by 2020, to join up disparate systems and bring the health service into the 21st century. But with 90 regional groupings all tendering for new record management systems, compatibility and interoperability are far from guaranteed – particularly given the NHS’s record of IT projects. | NHS England has pledged to move the health service to be paperless at the point of care by 2020, to join up disparate systems and bring the health service into the 21st century. But with 90 regional groupings all tendering for new record management systems, compatibility and interoperability are far from guaranteed – particularly given the NHS’s record of IT projects. |
| The NHS is still saddled with ancient computer systems, many of which still run the 14-year-old, unsupported and vulnerable Windows XP. But the NHS currently doesn’t know how many machines it has or what software they are running, which is what the Digital Maturity Assessment, due this month, will uncover and hopefully be able to phase out. | The NHS is still saddled with ancient computer systems, many of which still run the 14-year-old, unsupported and vulnerable Windows XP. But the NHS currently doesn’t know how many machines it has or what software they are running, which is what the Digital Maturity Assessment, due this month, will uncover and hopefully be able to phase out. |
| For the immediate term patients should expect repeat questioning, testing and forgetting who they are each time they visit, but there is light at the end of the 2020 tunnel, should the joined-up system work. | For the immediate term patients should expect repeat questioning, testing and forgetting who they are each time they visit, but there is light at the end of the 2020 tunnel, should the joined-up system work. |
| Updated | Updated |
| at 11.21am GMT | at 11.21am GMT |
| 10.10am GMT | 10.10am GMT |
| 10:10 | 10:10 |
| Chris Stanley, newly qualified GP | Chris Stanley, newly qualified GP |
| Jessica Elgot | Jessica Elgot |
| Chris Stanley, one of the Gale Farm practice’s newly qualified GPs, is seeing patients from 8.30am in the large office he was chuffed to acquire from a retired senior partner. | Chris Stanley, one of the Gale Farm practice’s newly qualified GPs, is seeing patients from 8.30am in the large office he was chuffed to acquire from a retired senior partner. |
| “The variety is massive. On one day last week I did a home visit to a member of the House of Lords, and a few hours later I saw a man living on the streets, an intravenous drug user. That’s not unusual, to see that difference in just a few hours.” | “The variety is massive. On one day last week I did a home visit to a member of the House of Lords, and a few hours later I saw a man living on the streets, an intravenous drug user. That’s not unusual, to see that difference in just a few hours.” |
| The practice holds 12-minute appointments, longer than the standard 10. A few years ago, the normal time was five minutes. “It still feels not long enough sometimes, especially when a patient has such long and complex list of problems.” | The practice holds 12-minute appointments, longer than the standard 10. A few years ago, the normal time was five minutes. “It still feels not long enough sometimes, especially when a patient has such long and complex list of problems.” |
| Even in his short time as a GP, Stanley said he has learnt so much from patients: | Even in his short time as a GP, Stanley said he has learnt so much from patients: |
| I once got a baby in, a few days old, with a chest infection, which is horrible in a tiny baby. I listened to the heart too and it didn’t sound quite right either. We called an ambulance and sent the family to hospital, just in case. | I once got a baby in, a few days old, with a chest infection, which is horrible in a tiny baby. I listened to the heart too and it didn’t sound quite right either. We called an ambulance and sent the family to hospital, just in case. |
| I almost forgot all about it, but got a letter back saying the baby had gone into cardiac arrest in the ambulance and the hospital had saved the baby’s life; it has a really rare heart condition. I essentially saved the baby’s life by accident, just by checking a chest infection. Now I always check the heartbeat whenever a baby comes in with chest infection. | I almost forgot all about it, but got a letter back saying the baby had gone into cardiac arrest in the ambulance and the hospital had saved the baby’s life; it has a really rare heart condition. I essentially saved the baby’s life by accident, just by checking a chest infection. Now I always check the heartbeat whenever a baby comes in with chest infection. |
| Stanley’s first patient of the day takes 15 regular medications, for conditions including asthma, blood pressure and arthritis. He’s here for the result of a blood test which he asked for because he’s concerned about memory problems, but the blood test rules out any obvious problems. | Stanley’s first patient of the day takes 15 regular medications, for conditions including asthma, blood pressure and arthritis. He’s here for the result of a blood test which he asked for because he’s concerned about memory problems, but the blood test rules out any obvious problems. |
| The GP arranges to do a memory test, and checks various other concerns the man has about headaches. “You can see a patient who has had many different problems in the same 12 minutes, with several unrelated concerns you have to address,” he said. “And you also have to bear in mind each of the medications someone is on which might affect different symptoms.” | The GP arranges to do a memory test, and checks various other concerns the man has about headaches. “You can see a patient who has had many different problems in the same 12 minutes, with several unrelated concerns you have to address,” he said. “And you also have to bear in mind each of the medications someone is on which might affect different symptoms.” |
| His second patient is worried about a lump they have found, which Stanley refers for more checks, and a third is recovering from a knee injury but wants get back to work so Stanley writes a note for him. | His second patient is worried about a lump they have found, which Stanley refers for more checks, and a third is recovering from a knee injury but wants get back to work so Stanley writes a note for him. |
| Another patient has what initially appears to be a water infection. She tells Stanley that she has been treated for that already without any improvement, and is keen for an x-ray to rule out cancer. Stanley examines her, and says he is unsure of the cause of the pain, agreeing to send her to hospital for the scan to put her fears at rest, though he does not think cancer is the cause. | Another patient has what initially appears to be a water infection. She tells Stanley that she has been treated for that already without any improvement, and is keen for an x-ray to rule out cancer. Stanley examines her, and says he is unsure of the cause of the pain, agreeing to send her to hospital for the scan to put her fears at rest, though he does not think cancer is the cause. |
| “I do always try to be reassuring – especially when I’m sure it’s isn’t actually what the patient thinks it is. But in other cases, you don’t want to be overly reassuring, because then the patient might not come back if it gets worse,” he said. | “I do always try to be reassuring – especially when I’m sure it’s isn’t actually what the patient thinks it is. But in other cases, you don’t want to be overly reassuring, because then the patient might not come back if it gets worse,” he said. |
| Updated | Updated |
| at 11.18am GMT | at 11.18am GMT |
| 9.51am GMT | 9.51am GMT |
| 09:51 | 09:51 |